A prediction model of contrast-associated acute kidney injury in patients with hypoalbuminemia undergoing coronary angiography
A prediction model of contrast-associated acute kidney injury in patients with hypoalbuminemia undergoing coronary angiography
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冠状动脉造影低蛋白血症患者对比剂相关急性肾损伤的预测模型
DOI：
10.1186/s12872-020-01689-6
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发表时间：
2020-08
影响因子：
2.1
通讯作者：
Chen Jiyan
中科院分区：
文献类型：
--
作者：
Liu Liwei;Liu Jin;Lei Li;Wang Bo;Sun Guoli;Guo Zhaodong;He Yibo;Song Feier;Lun Zhubin;Liu Bowen;Chen Guanzhong;Chen Shiqun;Yang Yongquan;Liu Yong;Chen Jiyan
背景风险分层被推荐为预防高危患者在冠状动脉造影（CAG）和/或经皮冠状动脉介入治疗（PCI）后造影剂相关急性肾损伤（CA-AKI）的关键步骤。低白蛋白血症患者容易发生CA-AKI，并且没有自己的风险分层工具。因此，本研究建立并验证了CAG/PCI低白蛋白血症患者CA-AKI预测的新模型。方法纳入1272例接受CAG/PCI治疗的低白蛋白血症患者，按2:1的比例随机分为发展组（n= 848）和验证组（n= 424）。CA-AKI定义为CAG/PCI后48 - 72小时内血清肌酐（SCr）较基线升高≥0.3 mg/dL或50%。根据逐步逻辑回归建立了具有独立预测因子的预测模型，表示为正态图。用曲线下面积（AUC）评价新模型的判别性，并与经典的Mehran CA-AKI模型进行比较。采用Hosmer-Lemeshow检验来评估模型的校准。结果发展组和验证组分别有8.4%（71/848）和11.2%（48/424）患者发生CA-AKI。新的心电图包括肾小球滤过率（eGFR）、血清白蛋白（ALB）、年龄和使用主动脉内球囊泵（IABP）；预测能力优于Mehran评分（c指数0.756比0.693,p= 0.02）；校正效果良好（Hosmer-Lemeshow检验p= 0.187）。结论：我们建立了一个预测低白蛋白血症患者行CAG/PCI的CA-AKI的简单模型，但我们的发现需要外部验证。试验注册：www.ClinicalTrials.gov NCT01400295，回顾性注册于2011年7月21日。
BackgroundRisk stratification is recommended as the key step to prevent contrast-associated acute kidney injury (CA-AKI) among at-risk patients following coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). Patients with hypoalbuminemia are prone to CA-AKI and do not have their own risk stratification tool. Therefore, this study developed and validated a new model for predicting CA-AKI among hypoalbuminemia patients CAG/PCI.Methods1272 patients with hypoalbuminemia receiving CAG/PCI were enrolled and randomly allocated (2:1 ratio) into the development cohort (n= 848) and the validation cohort (n= 424). CA-AKI was defined as an increase of ≥0.3 mg/dL or 50% in serum creatinine (SCr) compared to baseline in the 48 to 72 h after CAG/PCI. A prediction model was established with independent predictors according to stepwise logistic regression, showing as a nomogram. The discrimination of the new model was evaluated by the area under the curve (AUC) and was compared to the classic Mehran CA-AKI model. The Hosmer-Lemeshow test was conducted to assess the calibration of our model.ResultsOverall, 8.4% (71/848) patients of the development group and 11.2% (48/424) patients of the validation group experienced CA-AKI. A new nomogram included estimated glomerular filtration rate (eGFR), serum albumin (ALB), age and the use of intra-aortic balloon pump (IABP); showed better predictive ability than the Mehran score (C-index 0.756 vs. 0.693,p= 0.02); and had good calibration (Hosmer–Lemeshow testp= 0.187).ConclusionsWe developed a simple model for predicting CA-AKI among patients with hypoalbuminemia undergoing CAG/PCI, but our findings need validating externally.Trial registrationhttp://www.ClinicalTrials.gov NCT01400295 , retrospectively registered 21 July 2011.
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影响因子：
5.3
作者：
通讯作者：
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影响因子：
5.5
作者：
通讯作者：
--
DOI：
--
发表时间：
2014
期刊：
--
影响因子：
--
作者：
Stephan Achenbach;Helmut Baumgartner;J. J. Bax-J.;V. Dean;Christi Deaton;Çetin Erol;R. Fagard
通讯作者：
Stephan Achenbach;Helmut Baumgartner;J. J. Bax-J.;V. Dean;Christi Deaton;Çetin Erol;R. Fagard
影响因子：
2.3
作者：
Koo HM;Doh FM;Ko KI;Kim CH;Lee MJ;Oh HJ;Han SH;Kim BS;Yoo TH;Kang SW;Choi KH
通讯作者：
Choi KH
影响因子：
2.6
作者：
Joubert, Jean-Michel;Gottenberg, Jacques-Eric;Vasmant, Daniel
通讯作者：
Vasmant, Daniel